CN114073560A - Plugging device - Google Patents

Plugging device Download PDF

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Publication number
CN114073560A
CN114073560A CN202010808213.2A CN202010808213A CN114073560A CN 114073560 A CN114073560 A CN 114073560A CN 202010808213 A CN202010808213 A CN 202010808213A CN 114073560 A CN114073560 A CN 114073560A
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China
Prior art keywords
proximal
gathering
distal
gathered
sleeve
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Granted
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CN202010808213.2A
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Chinese (zh)
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CN114073560B (en
Inventor
李安宁
刘建勇
唐玉华
贾佳
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Lifetech Scientific Shenzhen Co Ltd
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Lifetech Scientific Shenzhen Co Ltd
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Priority to CN202010808213.2A priority Critical patent/CN114073560B/en
Application filed by Lifetech Scientific Shenzhen Co Ltd filed Critical Lifetech Scientific Shenzhen Co Ltd
Priority to CN202211326549.0A priority patent/CN115708702A/en
Priority to CN202211310370.6A priority patent/CN115670565A/en
Priority to EP21855581.1A priority patent/EP4197455A4/en
Priority to CA3186828A priority patent/CA3186828A1/en
Priority to PCT/CN2021/112111 priority patent/WO2022033530A1/en
Priority to US18/040,180 priority patent/US20230320713A1/en
Publication of CN114073560A publication Critical patent/CN114073560A/en
Application granted granted Critical
Publication of CN114073560B publication Critical patent/CN114073560B/en
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12099Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder
    • A61B17/12109Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12099Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder
    • A61B17/12109Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel
    • A61B17/12113Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel within an aneurysm
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12099Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder
    • A61B17/12122Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder within the heart
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12131Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
    • A61B17/12159Solid plugs; being solid before insertion
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12131Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
    • A61B17/12168Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device having a mesh structure
    • A61B17/12172Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device having a mesh structure having a pre-set deployed three-dimensional shape
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022Occluding by internal devices, e.g. balloons or releasable wires
    • A61B2017/1205Introduction devices
    • A61B2017/12054Details concerning the detachment of the occluding device from the introduction device
    • A61B2017/12095Threaded connection

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Molecular Biology (AREA)
  • Vascular Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Reproductive Health (AREA)
  • Medical Informatics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Cardiology (AREA)
  • Neurosurgery (AREA)
  • Surgical Instruments (AREA)

Abstract

The invention relates to a plugging device which comprises a first part, wherein the first part comprises a plurality of knitting wires and a bundling part, one ends of the knitting wires are fixed on the bundling part, the first part is provided with at least one disc surface, one part of the knitting wires form a gathering part through shape convergence, the bundling part is positioned in a space enclosed by the gathering part, and at least one disc surface formed by the matching of the gathering part is flat and closed. The occlusion device can ensure that the constriction piece does not protrude out of the disc surface at the periphery of the first part, thereby avoiding the blood stream from forming thrombus near the constriction piece and improving the safety of the occlusion device.

Description

Plugging device
Technical Field
The invention relates to the technical field of interventional medical instruments, in particular to a plugging device for plugging an internal opening.
Background
Plugging devices such as left atrial appendage occluders, atrial septal defect occluders, aneurysm occluders and the like are increasingly trusted by doctors and patients due to the characteristics that the plugging device has excellent plugging performance and almost no complications which can endanger life after being implanted into the bodies of the patients. In these occluders, the sealing disc for occluding the internal opening is generally woven into a mesh tube by a woven wire, and both ends of the mesh tube need to be closed and fixed by a plug.
The existing plug head is often protruded out of the disc surface of the sealing disc after one end of the knitting yarn is closed, so when the disc surface and the plug head are exposed in blood flow, thrombus is easily formed at the plug head, and after the thrombus flows into the brain of a human body along with the blood flow, the thrombus is easy to block blood vessels, induce stroke and damage the health of the human body.
Disclosure of Invention
In view of the above, it is necessary to provide a new occlusion device to solve the problem that the plug head protrudes from the disk surface of the sealing disk and is liable to form thrombus in the existing occlusion device.
The utility model provides a plugging device, includes the first part, the first part includes many braids silk and bunches, the one end of many braids silk is fixed in the piece of bunching, the first part has at least one quotation, some of many braids silk form through the shape convergence portion that gathers together, the piece of bunching is located gather together the portion and enclose the space that closes, and by gather together at least one that the portion cooperation formed the quotation is flat and confined.
In one embodiment, the gathering part comprises a first gathering part and a second gathering part, and the first gathering part and the second gathering part are close to each other when no external force acts on the gathering part, so that the bundling piece is enclosed in a space enclosed by the first gathering part and the second gathering part; the first gathering part and the second gathering part can be far away from each other under the action of external force.
In one embodiment, the maximum outer diameter of a gap formed after the first gathered part and the second gathered part are close to each other is less than or equal to 5 mm; or the first gathering part and the second gathering part are close to each other and are attached to each other at least in the radial direction.
In one embodiment, a gap formed by the first gathered part and the second gathered part is provided with a closing part, so that at least one disc surface formed by the cooperation of the gathered parts is closed.
In one embodiment, the first gathering portion comprises at least one protruding portion, the second gathering portion comprises at least one recessed portion, and after the first gathering portion and the second gathering portion are close to each other, at least one protruding portion abuts against one recessed portion.
In one embodiment, the first part is further provided with a resetting piece, and after the first gathering part and the second gathering part are relieved from the external force, the resetting piece gathers the first gathering part and the second gathering part together.
In one embodiment, the reset piece comprises at least two magnets with opposite magnetism, and the first gathered part and the second gathered part gather together under the action of the at least two magnets.
In one embodiment, the reset piece comprises a first reset rod and a second reset rod, the first reset rod is arranged close to the first gathering part, the second reset rod is arranged close to the second gathering part, and the first gathering part and the second gathering part gather together under the action of the first reset rod and the second reset rod.
In one embodiment, the reset piece comprises at least one elastic coil connecting the first gathered part and the second gathered part, and the first gathered part and the second gathered part gather together under the action of the elastic coil.
In one embodiment, the occlusion device further comprises a membrane member covering at least part of the outer surface of the bunched portion.
In the plugging device, the first part is provided with the gathering part formed by converging part of the plurality of braided wires in shape, and meanwhile, the disk surface formed by matching the gathering part is flat and closed, so the gathering part can surround the bundling piece in the space enclosed by the gathering part, the bundling piece can not protrude out of the disk surface positioned at the periphery of the first part, thrombus formed by blood flow near the bundling piece is avoided, and the safety of the plugging device is improved.
Drawings
FIG. 1 is a schematic view of the overall structure of the occlusion device of example 1;
FIG. 2 is a schematic view of one of the structures of the first part in example 1;
FIG. 3 is an enlarged schematic view of a dotted circle in FIG. 2;
FIG. 4 is another schematic structural view of the first part in embodiment 1;
FIG. 5 is another schematic structural view of the first part in embodiment 1;
FIG. 6 is an enlarged schematic view of a dotted circle in FIG. 5;
FIG. 7 is another schematic structural view of the first part in embodiment 1;
FIG. 8 is an enlarged schematic view of the dotted circle in FIG. 7;
FIG. 9 is another schematic structural view of the first part in embodiment 1;
FIG. 10 is an enlarged schematic view of the dotted circle in FIG. 9;
FIG. 11 is a schematic view showing an expanded structure of a film member provided with openings according to example 1;
FIG. 12 is a schematic view showing one of the structures of the first part in embodiment 3;
FIG. 13 is an enlarged schematic view of the dotted circle in FIG. 12;
FIG. 14 is a schematic view of a deployed configuration at the proximal end of the first section in example 5;
FIG. 15 is a schematic view showing one of the structures of the first part in example 6;
FIG. 16 is an enlarged schematic view of another implementation of the dotted circle portion in FIG. 15;
FIG. 17 is an enlarged schematic view of another implementation of the dotted circle portion in FIG. 15;
FIG. 18 is a schematic view of one of the structures of a binding member in embodiment 6;
FIG. 19 is a schematic view showing an overall structure of a plugging device according to example 10;
FIG. 20A is the schematic view showing the block device of example 10 implanted in the body tissue and connected to the delivery wire;
FIG. 20B is a schematic longitudinal cross-sectional view of the first portion of FIG. 20A;
FIG. 21A is the schematic view showing the block device of example 10 implanted in the body tissue and disconnected from the delivery wire;
FIG. 21B is a schematic longitudinal cross-sectional view of the first portion of FIG. 21A;
FIG. 22 is another schematic view of the first part in example 10;
FIG. 23 is another schematic structural view of the first part in example 10;
FIG. 24 is another schematic view of the structure of the first part in embodiment 10;
fig. 25 is another schematic structural view of the first part in embodiment 10.
Detailed Description
In order to make the objects, technical solutions and advantages of the present invention more apparent, the present invention is described in further detail below with reference to the accompanying drawings and embodiments. It should be understood that the specific embodiments described herein are merely illustrative of the invention and are not intended to limit the invention.
In the field of interventional medical devices, the end of a medical device implanted in a human or animal body closer to an operator is generally referred to as the "proximal end", the end farther from the operator is referred to as the "distal end", and the "proximal end" and the "distal end" of any component of the medical device are defined according to this principle. "axial" generally refers to the length of the medical device as it is being delivered, and "radial" generally refers to the direction of the medical device perpendicular to its "axial" direction, and defines both "axial" and "radial" directions for any component of the medical device in accordance with this principle.
In this application, the relatively proximal-located constriction is referred to as the proximal constriction, and the relatively distal-located constriction is referred to as the distal constriction. Similarly, the disc surface located at the relatively near end is called the near-end disc surface, and the disc surface located at the relatively far end is called the far-end disc surface. The technical solution of the present invention will be described in further detail with reference to specific examples.
Example 1
Referring to the occluding device 100 shown in figure 1, the occluding device 100 comprises a first portion 110 relatively located at a proximal end and a second portion 120 relatively located at a distal end, the distal end of the first portion 110 is directly connected to the proximal end of the second portion 120, or the distal end of the first portion 110 is indirectly connected to the proximal end of the second portion 120 by at least one connecting member 130, and the connecting member 130 can be rigid or flexible. In some embodiments, the first portion 110 can be used to occlude an opening or orifice in tissue in the body and the second portion 120 can be used to secure the occluding device 100 within a cavity in tissue in the body, for example, where the occluding device 100 is used to occlude an opening in the left atrial appendage. Further, the second portion 120 may also be used to close off openings or pores in the body tissue. In other embodiments, both the first portion 110 and the second portion 120 can be used to occlude an opening or hole in body tissue, for example, where the occluding device 100 is used to occlude an ostium of an atrial septum or a ventricular septum, or where an foramen ovale is patent, where the first portion 110 and the second portion 120 cooperate to secure the occluding device 100 in proximity to an opening or hole in body tissue.
The first portion 110 includes a plurality of braided filaments 111 and two bunches 112/113, wherein each braided filament 111 has opposite proximal and distal ends, wherein the plurality of braided filaments 111 may be braided to form a mesh tube shape, and wherein the plurality of braided filaments 111 also includes opposite proximal and distal ends and assumes a disc or column like shape after being heat set. Thus, the first portion 110 includes at least a proximal disc surface 114 and a distal disc surface 115. The proximal disc surface 114 of the first portion 110 is cooperatively formed by portions of the plurality of braided wires 111 of the first portion 110 that are proximate to the proximal ends of the plurality of braided wires 111. The distal disc surface 115 of the first portion 110 is cooperatively formed by portions of the plurality of braided wires 111 of the first portion 110 that are proximate to the distal ends of the plurality of braided wires 111. The portion of the first portion 110 where the proximal disk face 114 and the distal disk face 115 join forms an edge 116 of the first portion 110.
The proximal end constriction 112 of the first portion 110 includes an inner sleeve and an outer sleeve, both hollow and sleeved, and the proximal ends of the plurality of braided wires 111 are received and secured between the inner sleeve and the outer sleeve, thereby securing the proximal ends of the plurality of braided wires 111 to the proximal constriction 112. The distal end constriction 113 of the first portion 110 may be a hollow sleeve for receiving and securing the distal ends of the plurality of braided wires 111 within the sleeve, thereby securing the distal ends of the plurality of braided wires 111 to the distal constriction 113. In another embodiment, the distal end restriction 113 of the first portion 110 may also be configured the same as the proximal end restriction 112 of the first portion 110, i.e., including an inner sheath and an outer sheath both hollow and sleeved for receiving and securing the distal ends of the plurality of braided wires 111 between the inner sheath and the outer sheath of the distal end restriction 113.
The specific structure of the second portion 120 is not limited as long as the occluding device 100 can be secured within the lumen of the body tissue after release. For example, the second portion 120 may be obtained by laser cutting an alloy tube having shape memory characteristics and heat-setting, or may be obtained by weaving a plurality of weaving filaments 111 and heat-setting. The distal portion of the second portion 120 may be closed or may have an opening. In this embodiment, second portion 120 includes a plurality of braided wires 121 and two constrictions 122/123, wherein the plurality of braided wires 121 may be braided to form a cylindrical mesh, a proximal end of the mesh being received and secured by proximal constrictions 122 of second portion 120 and a distal end of the mesh being received and secured by distal constrictions 123 of second portion 120.
The proximal constriction 122 of the second portion 120 may include inner and outer sleeves, both hollow and sleeved, for receiving and securing the proximal ends of the plurality of braided wires 121 of the second portion 120 therebetween. In another embodiment, the proximal end constriction 122 of the second portion 120 may also be a hollow sleeve for receiving and securing the proximal ends of the plurality of braided wires 121 of the second portion 120 within the sleeve.
The distal end constriction 123 of the second portion 120 may also be a hollow sleeve for receiving and securing the distal ends of the plurality of braided wires 121 of the second portion 120 within the sleeve. In another embodiment, the distal end constriction 123 of the second portion 120 may also be of the same structure as the proximal end constriction 112 of the first portion 110, i.e., including an inner sleeve and an outer sleeve both hollow and sleeved for receiving and securing the distal ends of the plurality of braided wires 121 of the second portion 120 therebetween.
In other embodiments, when the first portion 110 and the second portion 120 are integrally formed, the distal end of the first portion 110 may not be provided with the distal end stop 113, and the proximal end of the second portion 120 may not be provided with the proximal end stop 122.
The occlusion device 100 further comprises a membrane member, which may be arranged in the first portion 110 and/or the second portion 120. When the membrane member is disposed on the first portion 110, the membrane member 117 covers at least the outer surface of the proximal disc surface 114 of the first portion 110, and the constricted region 118 of the membrane member 117 is at least partially secured within the proximal constriction 112 of the first portion 110, thereby ensuring a sufficiently good seal at the proximal end of the first portion 110, while at the same time securing the constricted region 118 of the membrane member 117 securely by the proximal constriction 112. In other embodiments, the membrane 117 covers a portion of the outer surface of the proximal disc face 114 of the first portion 110 to purposely enhance the sealing of localized areas of the proximal disc face 114 as desired. In other embodiments, the film 117 on the first portion 110 may further cover the edge 116 of the first portion 110. Further, in other embodiments, the thin film member 117 on the first portion 110 may also cover the distal disk surface 115 of the first portion 110, i.e., the thin film member 117 covers the proximal disk surface 114, the rim 116, and the distal disk surface 115 of the first portion 110. The constricted region 118 of the film 117 refers to the portion of the film 117 located adjacent the constriction, which may be located centrally or elsewhere in the film 117; when the membrane 117 is secured by the proximal or distal constricting elements 112, 123, the constricted region 118 of the membrane 117 may refer to the portion of the membrane 117 adjacent the respective proximal or distal constricting element 112, 123. Similarly, a constricted region 125 of the film member 124 on the second portion 120 may be defined.
The film member 117 may be made of a PET film or a PTFE film, and thus not only has good sealability, but also promotes endothelial attachment to the film member 117 under the impact of blood flow, thereby further improving sealability.
As shown in fig. 1 to 3, the proximal disc surface 114 and the edge 116 of the first portion 110 are covered with a thin film member 117, and the thin film member 117 may be one or more layers. A portion of the constricted region 118 of the membrane 117 is fixed in the proximal constriction 112 of the first portion 110, specifically, may be fixed by being clamped between the inner tube 1121 and the outer tube 1122 of the proximal constriction 112, or may be fixed relatively by being clamped on the inner tube 1121 and the outer tube 1122 and connecting the inner tube 1121 and the outer tube 1122 together. Other portions of the thin film member 117 may be sewn to the proximal disc face 114 of the first portion 110 by sutures or may be adhesively bonded to the proximal disc face 114 of the first portion 110. The edge of the thin film 117 covers the edge 116 of the first portion 110, so as to reduce the damage of the edge 116 of the first portion 110 to the tissue in the body, such as scraping. The edges of the membrane 117 may be secured by stitching to the woven filaments 111 at the rim 116, by adhesive bonding or the like. The proximal ends of the plurality of braided wires 111 in the first portion 110 are fixed between the inner tube 1121 and the outer tube 1122 of the proximal end restraining member 112, and the fixing method may be clamping by the inner tube 1121 and the outer tube 1122, or may be fixing the proximal ends of the plurality of braided wires 111 to the distal end of the outer tube 1122 by welding or the like, and the fixing method is not limited.
The membrane 117 may be a complete circular membrane without any significant openings. After the membrane 117 is interposed between the inner tube 1121 and the outer tube 1122 of the proximal end restriction member 112, the distal opening 1123 of the inner tube 1121 is covered by the centermost portion of the membrane 117, thereby occluding the distal opening 1123 of the inner tube 1121 to prevent blood flow through the inner tube 1121 into the first portion 110, and improving the sealing performance of the occlusion device 100.
Further, the inner wall of the inner sleeve 1121 of the proximal end constriction 112 of the first portion 110 is provided with a thread 1124 or a snap-in member, which can be matched with the distal end of the delivery cable to realize a detachable connection, so as to achieve the purposes of being able to deliver the occlusion device 100 when the proximal end constriction 112 of the first portion 110 is connected with the delivery cable, and completely releasing the occlusion device 100 and recovering the delivery cable when the connection is broken. In other embodiments, the inner wall of the inner sleeve 1121 of the constricting element may not have threads 1124 or snap-fit elements.
Further, a limiting member 1125 extending radially or having an angle with the central axis of the inner sleeve 1121 is disposed in the cavity of the inner sleeve 1121 of the proximal end constriction 112 of the first portion 110, and can be used to limit the depth of the delivery cable extending into the inner sleeve 1121 when connected to the proximal end constriction 112, so as to prevent the distal end of the delivery cable from sticking to the film 117 located on the distal end surface of the proximal end constriction 112, and can also be used to fix the film 117 on the proximal end constriction 112, so as to further enhance the stability of the film 117 in the proximal end constriction 112. In this embodiment, the limiting member 1125 is a pin inserted through the wall of the inner tube 1121 of the proximal end restraining member 112 and the wall of the outer tube 1122, two opposite through holes are formed in the wall of the inner tube 1121, two opposite through holes are also formed in the wall of the outer tube 1122, one end of the pin sequentially penetrates through the through holes of the outer tube 1122, the inner tube 1121 and the outer tube 1122 from outside to inside, and finally two ends of the pin are respectively received and fixed in the two through holes of the outer tube 1122. In other embodiments, the limiting member 1125 may be another rod-shaped component, and both ends of the limiting member 1125 may extend outward beyond the wall of the outer sleeve 1122; further, both ends of the restriction member 1125 are restricted by the shape after protruding out of the tube wall of the outer tube 1122 to form a restriction to the movement of the restriction member 1125 in the radial direction, for example, both ends of the restriction member 1125 are provided with protrusions in a ball shape or other shapes as long as the outer diameter of the protrusion in the axial direction is larger than the diameter of the through hole for receiving the restriction member 1125 in the tube wall of the outer tube 1122. In other embodiments, the limiting member 1125 only penetrates through the wall of the inner tube 1121, and both ends of the limiting member 1125 are respectively received and fixed in two through holes of the inner tube 1121. In other embodiments, the limiter 1125 may not be disposed within the proximal constriction 112.
In this embodiment, at least a portion 1141 of the proximal disc surface 114 of the first portion 110, which is close to the proximal binding member 112, is perpendicular to the central axis of the proximal binding member 112, so that a relatively flat disc surface is formed near the proximal binding member 112, thereby preventing the risk of thrombus formation near the proximal binding member 112 and improving safety. Wherein, the flat disk surface means that there is no obvious convex part on the surface of the disk surface, even if there are several convex parts, the height of the convex part protruding outwards relative to other parts is less than or equal to 2 mm. In other embodiments, as shown in FIG. 4, at least a portion 1142 of the proximal disc surface 114 of the first portion 110 that is adjacent to the proximal binding 112 may be disposed non-perpendicular to the central axis of the proximal binding 112.
Further, in other embodiments, as shown in fig. 4-6, the proximal end of the proximal constriction 112 is provided with an end cap 1126 connected to the inner sleeve 1121, and the constriction region 118 of the membrane 117 is at least partially received or secured between the end cap 1126 and the outer sleeve 1122 to further securely secure the membrane 117 within the proximal constriction 112. The proximal ends of the plurality of braided wires 111 of the first portion 110 extend from the gap between the end cap 1126 and the outer sleeve 1122 into the gap between the inner sleeve 1121 and the outer sleeve 1122 until reaching the distal end of the outer sleeve 1122, and then are fixed to the distal end of the proximal end restraint 112 by welding or the like. In other embodiments, the distal end of the proximal end restriction 112 may also be provided with an end cap 1126 connected to the outer sleeve 1122 or the inner sleeve 1121 to further secure the membrane 117 within the proximal end restriction 112 and to close off the opening at the distal end of the proximal end restriction 112 for improved sealing.
In the embodiment shown in FIGS. 5 and 6, the converging region 118 of the membrane 117 is provided with an opening 1171 as shown in FIG. 11, and the portion of the membrane 117 that surrounds the opening 1171 is received and secured within the proximal converging member 112. Specifically, the portion of the film 117 surrounding the opening 1171 extends from the gap between the end cap 1126 and the outer sleeve 1122 into the gap between the inner sleeve 1121 and the outer sleeve 1122, and then is clamped between the inner sleeve 1121 and the outer sleeve 1122 in a ring or tube shape together with a portion of the plurality of braided wires 111. Such a membrane 117 may be used in situations where it is desired that the distal opening 1123 of the proximal end restriction member 112 not be closed, such as where it is desired to deliver a substance or component distally through the distal opening 1123. In other embodiments, the end cap 1126 may have a slot therein, and the portion of the film 117 that surrounds the opening 1171 may be securely clamped in the slot of the end cap 1126. In other embodiments, the limiter 1125 or the end cap 1126 may not be included in the proximal constriction 112, or the threads 1124 or the snap-fit element may not be included in the inner sleeve 1121.
The proximal end of the inner tube 1121 and the proximal end of the outer tube 1122 enclose a proximal inlet of the proximal restraint 112, the distal end of the inner tube 1121 and the distal end of the outer tube 1122 enclose a distal inlet of the proximal restraint 112, and the proximal ends of the plurality of braided wires 111 of the first portion 110 are received or fixed between the inner tube 1121 and the outer tube 1122 after passing through the proximal inlet or the distal inlet of the proximal restraint 112. Specifically, when the proximal ends of the plurality of braided wires 111 of the first portion 110 are received and secured through the proximal inlet of the proximal restraint 112, as shown in fig. 3 and 6, the constricted region 118 of the membrane 117 is at least partially secured between the inner sleeve 1121 and the outer sleeve 1122 via the proximal inlet 1127 of the proximal restraint 112. When the proximal ends of the plurality of braided wires 111 of the first portion 110 are received and secured by the distal inlet 1128 of the proximal end restriction 112, as shown in fig. 7 and 8, the constricted region 118 of the membrane 117 is at least partially received or secured between the inner sleeve 1121 and the outer sleeve 1122 via the distal inlet 1128 of the proximal restriction 112. In other embodiments, when the proximal ends of the plurality of braided wires 111 of the first portion 110 are received and secured by the distal inlet 1128 of the proximal restraining member 112, as shown in fig. 9 and 10, the restrained region 118 of the membrane 117 is at least partially received or secured between the inner and outer sleeves 1121, 1122 via the proximal inlet 1127 of the proximal restraining member 112.
In other embodiments, the interior of the first portion 110 is further provided with at least one flow-blocking membrane for preventing blood from flowing from the proximal disc surface 114 of the first portion 110 into the interior of the first portion 110, thereby further improving the occlusion performance of the first portion 110.
Example 2
The same parts of the occluding device of embodiment 2 as those of embodiment 1 are not described again, but the difference between them is mainly that the proximal restraining element 112 or the distal restraining element 113 of the first part 110 described in embodiment 1 can be used for the second part 120 as well.
Specifically, similar to the configuration shown in FIG. 1, the membrane member 124 of the second portion 120 covers the outer surface and the rim 127 of the proximal disc face 126 of the second portion 120, and the constricted region 125 of the membrane member 124 is at least partially secured within the proximal constriction 122 of the second portion 120. The edges 127 of the second portion 120 are the side portions of the second portion 120 between the proximal disk face 126 and the distal disk face 128. Further, in other embodiments, the thin film member 124 on the second portion 120 may further cover the distal disk surface 128 of the second portion 120, i.e., the thin film member 124 covers the proximal disk surface 126, the rim 127 and the distal disk surface 128 of the second portion 120. In other embodiments, the film member 124 of the second portion 120 covers only the outer surface of the proximal disk face 126 or the outer surface of the distal disk face 128 of the second portion 120, or the outer surface of the distal disk face 128 and the rim 127. In other embodiments, the membrane member 124 may cover a portion of the outer surface of the proximal disc face 126 or the distal disc face 128 to purposely enhance the sealing of localized areas of the proximal disc face 126 or the distal disc face 128 as desired. On the basis, the above-mentioned various specific structures of the proximal end constraining member 112 disposed on the first portion 110 and the various specific ways of receiving and fixing the proximal ends of the plurality of braided wires 111 and the constraining region 118 of the thin film member 117 in embodiment 1 are also applicable to the proximal end constraining member 122 on the second portion 120, and are not repeated herein.
Example 3
The same parts of the occluding device of embodiment 3 as those of embodiment 1 are not described again, but the proximal end restriction member 112 described in embodiment 1 may be disposed at the distal end of the first portion 110 as the distal end restriction member 113, and the structures, the matching manner with the thin film member 117, the fixing manner in the restriction member, and other features of the two members are the same or similar.
Specifically, the membrane 117 of the first portion 110 covers at least a portion of the outer surface of the distal disc face 115 of the first portion 110, and the constricted region 118 of the membrane 117 is at least partially secured within the distal constriction 113 of the first portion 110. In other embodiments, the thin film member 117 on the first portion 110 further covers the edge 116 of the first portion 110. Further, in this embodiment, as shown in fig. 12, the thin film member 117 on the first portion 110 may also cover the proximal disc surface 114 of the first portion 110, i.e. the thin film member 117 covers the distal disc surface 115, the edge 116 and the proximal disc surface 114 of the first portion 110.
In some embodiments, as shown in fig. 12 and 13, the distal end of the first portion 110 includes an inner sleeve 1131 and an outer sleeve 1132, which are arranged from inside to outside, a proximal end of the inner sleeve 1131 and a proximal end of the outer sleeve 1132 enclose a proximal inlet 1133 of the distal end of the first portion 110, a distal end of the inner sleeve 1131 and a distal end of the outer sleeve 1132 enclose a distal inlet 1134 of the distal end of the first portion 110, and a distal end of the plurality of braided wires 111 of the first portion 110 is received or fixed between the inner sleeve 1131 and the outer sleeve 1122 after passing through the distal inlet 1134 of the distal end of the first portion 113. In other embodiments, the distal ends of the plurality of braided wires 111 of the first portion 110 are received or secured between the inner sleeve 1131 and the outer sleeve 1122 after passing through the proximal inlet 1133 of the distal end restriction 113.
Specifically, when the distal ends of the plurality of braided wires 111 of the first portion 110 are received and secured by the proximal inlet 1133 of the distal end restraint 113, the constricted region 118 of the membrane 117 is at least partially received or secured between the inner sleeve 1131 and the outer sleeve 1122 via the proximal inlet 1133 or the distal inlet 1134 of the distal end restraint 113. When the distal ends of the plurality of braided wires 111 of the first portion 110 are received and secured by the distal inlet 1134 of the distal restraining member 113, the restrained region 118 of the membrane 117 is at least partially received or secured between the inner sleeve 1131 and the outer sleeve 1122 via the distal inlet 1134 of the distal restraining member 113.
Example 4
The same parts of the occluding device of embodiment 4 as those of embodiment 3 are not described again, but the difference between the two parts is mainly that the distal end restriction member 113 of the first part 110 described in embodiment 3 can be used as the distal end restriction member 123 of the second part 120.
Specifically, the film member 124 of the second portion 120 covers at least a portion of the outer surface of the distal disc face 128 of the second portion 120, and the constricted region 125 of the film member 124 is at least partially secured within the distal constriction 123 of the second portion 120. In the embodiment shown in fig. 1, the thin film member 124 on the second portion 120 may further cover the edge 127 of the second portion 120, i.e., the side portion between the proximal disc surface 126 and the distal disc surface 128 of the second portion 120. Further, in other embodiments, the thin film member 124 on the second portion 120 may also cover the proximal disc surface 126 of the second portion 120, i.e., the thin film member 124 covers the distal disc surface 128, the rim 127 and the proximal disc surface 126 of the second portion 120. On the basis, the above-mentioned various specific structures of the distal end restriction member 113 disposed on the first portion 110 and the various specific ways of receiving and fixing the distal ends of the plurality of braided wires and the restriction region 118 of the thin film member 117 in embodiment 3 are also applicable to the distal end restriction member 123 on the second portion 120, and are not repeated herein.
Example 5
The same parts of the occluding device of embodiment 5 as those of embodiments 1 to 4 are not described again, but the main difference is that, as shown in fig. 14, the first portion 110 further includes an extension piece 119 located at the edge 116 of the first portion 110, the membrane piece 117 on the first portion 110 further covers the extension piece 119, and the extension piece 119 stretches the membrane piece 117 radially outward after being deployed. In this embodiment, the extension 119 is a plurality of semi-circular wires disposed at the edge 116 of the first portion 110, and both ends of the wires are fixed to the edge 116 of the first portion 110. The plurality of wires may be evenly distributed along the edge 116 of the first portion 110. Further, two adjacent filaments may be spaced apart or abut each other. As one of the embodiments, the filaments may be formed by a portion of the plurality of braided filaments 111 braided to form the first portion 110 projecting outwardly from the rim 116 of the first portion 110. In other embodiments, the filaments may be separate components, and both ends may be fixed in place on the edge 116 of the woven first portion 110, and may be semi-circular. The extension 119 may also have other shapes or configurations, so long as when the first portion 110 is released, the extension 119 expands and radially outwardly expands the membrane 117, such that the membrane 117 is evenly expanded over the outer surface of the first portion 110, thereby preventing the disk from wrinkling and thus creating a thrombus easily.
In other embodiments, the extending member 119 may be disposed on the edge 127 of the second portion 120, and the structure and the function thereof are the same, which are not described herein again.
Example 6
The same parts of the occlusion device of example 6 as those of example 1 are not described again, and the difference between the two parts is mainly that the constriction member of example 6 comprises an inner cannula, a middle cannula and an outer cannula which are all hollow and are sequentially sleeved from inside to outside. The constriction located relatively proximal to the first portion 110 is referred to as the proximal constriction 112 and the constriction located relatively distal to the first portion 110 is referred to as the distal constriction 123. The proximal ends of the plurality of braided wires 111 of the first portion 110, the constricted region 118 of the membrane element 117 are each at least partially received and secured within the proximal constriction 112 of the first portion 110.
After the proximal ends of the plurality of braided wires 111 of the first portion 110 are secured between the outer sleeve and the intermediate sleeve, the outer sleeve and the intermediate sleeve are also secured together. The inner sleeve and the outer sleeve can be directly or indirectly fixed together or the inner sleeve and the middle sleeve can be directly or indirectly fixed together by various modes such as the matching of the protrusions and the grooves or the matching of the protrusions and the through holes, so that the proximal end contracting component 112 with a relatively stable structure is formed. The specific structure and the matching manner are not limited, and are not listed one by one.
The distal end constriction 113 of the first portion 110 may be a hollow sleeve for receiving and securing the distal ends of the plurality of braided wires 111 within the sleeve. In another embodiment, the distal end restriction member 113 of the first portion 110 may also have the same structure as the proximal end restriction member 112 of the first portion 110, that is, include an inner sleeve, an intermediate sleeve and an outer sleeve, which are all hollow and are sequentially sleeved from inside to outside, for accommodating and fixing the distal ends of the plurality of knitting filaments 111 between the inner sleeve and the intermediate sleeve of the distal end restriction member 113, or between the intermediate sleeve and the outer sleeve.
As shown in fig. 15, the proximal disc surface 114 and the rim 116 of the first portion 110 are covered with a thin film member 117, and the thin film member 117 may be one or more layers. A portion of the constricted region 118 of the membrane element 117 is secured within the proximal constriction 112 of the first part 110, in particular by being clamped between the inner sleeve 2121 and the intermediate sleeve 2122 of the proximal constriction 112 so as to be secured, thereby ensuring that the proximal end of the first part 110 has a sufficiently good seal and at the same time the constricted region 118 of the membrane element 117 is securely held by the proximal constriction 112. Other portions of the thin film member 117 may be sewn to the proximal disc face 114 of the first portion 110 by sutures or may be adhesively bonded to the proximal disc face 114 of the first portion 110. The edge of the thin film member 117 covers the rim 116 of the first portion 110, which reduces the damage to the body tissue caused by the rim 116 of the first portion 110. The edges of the membrane 117 may be secured by stitching to the woven filaments 111 at the rim 116, by adhesive bonding or the like. The proximal ends of the plurality of braided wires 111 on the first portion 110 are fixed between the middle sleeve 2122 and the outer sleeve 2123 of the proximal binding 112 in a manner that the middle sleeve 2122 and the outer sleeve 2123 are clamped, or the proximal ends of the plurality of braided wires 111 are fixed between the middle sleeve 2122 and the outer sleeve 2123 by welding or the like, or the proximal ends of the plurality of braided wires 111 are welded and fixed to the distal end of the outer sleeve 2123, which is not limited.
The membrane 117 may be a complete circular membrane without the distinct opening 1171. After the thin film member 117 is sandwiched between the inner sleeve 2121 and the intermediate sleeve 2122 of the proximal binding member 112, the distal opening 2124 of the inner sleeve 2121 is covered by the centermost portion of the thin film member 117, thereby sealing off the distal opening 2124 of the inner sleeve 2121 to prevent blood flow through the inner sleeve 2121 into the first portion 110, and improving the sealing of the occlusion device.
Further, the inner wall of the inner sleeve 2121 of the proximal end constriction 112 of the first portion 110 is provided with a thread 1124 or a snap-in fitting to the distal end of the delivery cable for detachable connection, so as to achieve the purpose of being able to deliver the occlusion device when the proximal end constriction 112 of the first portion 110 is connected to the delivery cable, and to completely release the occlusion device and recover the delivery cable when the connection is broken. In other embodiments, the inner wall of the inner sleeve 2121 of the constriction may not have threads 1124 or snap-fit members.
In this embodiment, the portion of the proximal disc surface 114 of the first portion 110 adjacent to the proximal end restriction 112 is substantially conical around the outer sleeve 2123 so that it is not perpendicular to the central axis of the proximal end restriction 112. In other embodiments, at least a portion of the proximal disc surface 114 of the first portion 110 that is adjacent to the proximal binding 112 is perpendicular to the central axis of the proximal binding 112, thereby forming a relatively flat disc surface near the proximal binding 112 to avoid the risk of thrombus formation near the proximal binding 112 and improve safety.
The proximal end of the middle sleeve 2122 is flush with the proximal end of the inner sleeve 2121 and the proximal end of the outer sleeve 2123, respectively, the distal end of the outer sleeve 2123 is flush with the distal end of the inner sleeve 2121, the length of the middle sleeve 2122 is smaller than the length of the outer sleeve 2123 and the length of the inner sleeve 2121, and the proximal ends of the plurality of braided wires 111 are received and fixed between the middle sleeve 2122 and the outer sleeve 2123, wherein the specific position and fixing manner of the fixing points are not limited.
Further, a limiting member 1125 extending radially or at an angle to the central axis of the inner sleeve 2121 is provided in the cavity of the inner sleeve 2121 of the proximal constriction 112 of the first portion 110, and both ends of the limiting member 1125 penetrate through the wall of the inner sleeve 2121 to fix the limiting member 1125 and the inner sleeve 2121 together. The limiter 1125 can be used to limit the depth of the delivery cable extending into the interior of the inner sleeve 2121 when connected to the proximal end constraint 112, to prevent the distal end of the delivery cable from poking through the membrane 117 on the distal end face of the proximal end constraint 112, or to secure the membrane 117 to the proximal end constraint 112, to further enhance the securement of the membrane 117 within the proximal end constraint 112. The ends of the limiter 1125 further extend through the wall of the outer sleeve 2123 to secure the limiter 1125 to the outer sleeve 2123, thereby also connecting and securing the inner sleeve 2121 and the outer sleeve 2123 relative to each other.
In this embodiment, the limiting member 1125 is a pin inserted through the wall of the inner sleeve 2121 and the wall of the outer sleeve 2123 of the proximal constraining member 112, two through holes are formed in the wall of the inner sleeve 2121, two through holes are also formed in the wall of the outer sleeve 2123, one end of the pin sequentially penetrates through the through hole 2125 of the outer sleeve 2123, the through hole 2126 of the inner sleeve 2121, the through hole 2127 of the inner sleeve 2121 and the through hole 2128 of the outer sleeve 2123 from outside to inside, and finally, two ends of the pin are respectively received and fixed in the through hole 2125 and the through hole 2128 of the outer sleeve 2123. In other embodiments, the limiting member 1125 may be another rod-shaped component, and both ends of the limiting member 1125 may extend outward beyond the wall of the outer sleeve 2123; further, both ends of the restriction member 1125 are restricted by the shape after protruding out of the tube wall of the outer tube 2123 to form a restriction to the movement of the restriction member 1125 in the radial direction, for example, both ends of the restriction member 1125 are provided with protrusions in a ball head shape or other shapes as long as the outer diameter of the protrusion in the axial direction is larger than the diameter of the through hole for receiving the restriction member 1125 in the tube wall of the outer tube 2123. In other embodiments, the limiter 1125 may not be disposed within the proximal constriction 112.
In other embodiments, the limiter 1125 extends through only the wall of the inner sleeve 2121 and the two ends of the limiter 1125 are received and secured within the through holes 2126 and 2127, respectively, of the inner sleeve 2121. Further, in one embodiment, as shown in fig. 16, the limiting member 1125 only penetrates through the wall of the inner sleeve 2121, and both ends of the limiting member 1125 respectively protrude from the through hole 2126 and the through hole 2127 of the inner sleeve 2121 and are formed into a bulb shape by heat fusion or the like, so that the inner sleeve 2121 is clamped between the two bulbs, and at the same time, since both ends of the limiting member 1125 respectively penetrate through the film member 117, the part of the film member 117 near the limiting member 1125 is relatively fixed.
In other embodiments, the proximal end of the proximal collar 112 is provided with an end cap 1126 attached to the inner sleeve 2121, and the constricted region 118 of the membrane 117 is at least partially received or secured between the end cap 1126 and the outer sleeve 2123 to further securely secure the membrane 117 within the proximal collar 112. In one embodiment, as shown in fig. 16, the outer sleeve 2123 has a length corresponding to the length of the intermediate sleeve 2122, and the inner sleeve 2121 has a length greater than the length of the outer sleeve 2123 and greater than the length of the intermediate sleeve 2122. The proximal ends of the plurality of braided wires 111 on the first portion 110 extend from the space between the end cap 1126 and the outer sleeve 2123 into the space between the intermediate sleeve 2122 and the outer sleeve 2123 until they extend to the distal end of the intermediate sleeve 2122 and are secured, e.g., by welding, to the distal end of the intermediate sleeve 2122 and the distal end of the outer sleeve 2123. In other embodiments, end cap 1126 may further press membrane 117 against outer sleeve 2123 and/or intermediate sleeve 2122. In other embodiments, the distal end of the proximal end restriction 112 may also be provided with an end cap 1126 coupled to the outer sleeve 2123 or the inner sleeve 2121 to further secure the membrane material 117 within the proximal end restriction 112 and to close off the opening at the distal end of the proximal end restriction 112 for improved sealing.
In other embodiments, the converging region 118 of the membrane 117 is provided with an opening 1171 as shown in FIG. 11, and the portion of the membrane 117 that surrounds the opening 1171 is received and secured within the proximal converging member 112. Specifically, as shown in FIG. 17, the portion of the membrane 117 that surrounds the aperture 1171 extends from the space between the end cap 1126 and the outer sleeve 2123 and is secured between the outer sleeve 2123, the intermediate sleeve 2122 and the end cap 1126. In other embodiments, the portion of the film 117 that defines the opening 1171 can further extend between the inner sleeve 2121 and the middle sleeve 2122 or between the middle sleeve 2122 and the outer sleeve 2123, and can be clamped or snapped between two adjacent sleeves in a ring or tubular shape, as long as the proximal ends of the plurality of braided wires 111 are not affected to be fixed in the proximal end restraining member 112. Such a film member 117 may be used in situations where it is desired that the distal opening 2124 of the proximal bundling member 112 not be closed. In other embodiments, the limiter 1125 or the end cap 1126 may not be included in the proximal constriction 112, or the threads 1124 or snap-fit elements may not be included in the inner sleeve 2121.
As shown in FIG. 18, the proximal end of the outer sleeve 2123 and the proximal end of the intermediate sleeve 2122 enclose an outer proximal entrance 221 of the proximal hub 112, the proximal end of the intermediate sleeve 2122 and the proximal end of the inner sleeve 2121 enclose an inner proximal entrance 222 of the proximal hub 112, the distal end of the outer sleeve 2123 and the distal end of the intermediate sleeve 2122 enclose an outer distal entrance 223 of the proximal hub 112, and the distal end of the intermediate sleeve 2122 and the distal end of the inner sleeve 2121 enclose an inner distal entrance 224 of the proximal hub 112. As shown in fig. 15-17, the proximal ends of the plurality of braided wires 111 of the first portion 110 are received or secured between the outer sleeve 2123 and the intermediate sleeve 2122. In other embodiments, the proximal ends of the plurality of braided wires 111 of the first portion 110 are received or secured between the intermediate sleeve 2122 and the inner sleeve 2121. Specifically, the proximal ends of the plurality of braided filaments 111 of the first portion 110 are received or secured within the proximal end restraint 112 after passing through one of the outer proximal access 221, the outer distal access 223, and the inner distal access 224 of the proximal restraint 112.
As some of these embodiments, when the proximal ends of the plurality of braided wires 111 of the first portion 110 are received and secured by the outer proximal inlet 221 of the proximal binding 112, the constricted region 118 of the membrane 117 is at least partially secured between the inner sleeve 2121 and the intermediate sleeve 2122, or at least partially secured between the outer sleeve 2123, the intermediate sleeve 2122, and the end cap 1126, via the inner proximal inlet 222 of the proximal binding 112. When the proximal ends of the plurality of braided wires 111 of the first portion 110 are received and secured by the outer distal inlet 223 of the proximal binding 112, the binding region 118 of the membrane 117 is at least partially received or secured between two adjacent sleeves, or between the outer sleeve 2123, the intermediate sleeve 2122 and the end cap 1126, via the outer proximal inlet 221 or the inner proximal inlet 222 of the proximal binding 112. When the proximal ends of the plurality of braided wires 111 of the first portion 110 are received and secured by the inner distal access 224 of the proximal binding 112, the binding region 118 of the membrane element 117 is at least partially received or secured between the inner sleeve 2121 and the outer sleeve 2123, or at least partially secured between the outer sleeve 2123, the intermediate sleeve 2122 and the end cap 1126, via any one of the outer proximal access 221, the inner proximal access 222, and the outer distal access 223 of the proximal binding 112.
In other embodiments, the interior of the first portion 110 is further provided with at least one flow-blocking membrane for preventing blood from flowing from the proximal disc surface 114 of the first portion 110 into the interior of the first portion 110, thereby further improving the occlusion performance of the first portion 110.
Example 7
The same parts of the occluding device of embodiment 7 as those of embodiment 6 will not be described again, and the difference between the two parts is mainly that the proximal restraining element 112 or the distal restraining element 113 of the first part 110 described in embodiment 6 can be used as the proximal restraining element 122 or the distal restraining element 123 of the second part 120.
Specifically, the membrane member 124 of the second portion 120 covers at least a portion of the outer surface of the proximal disc face 126 of the second portion 120, and the constricted region 125 of the membrane member 124 is at least partially secured within the proximal constriction 122 of the second portion 120. In other embodiments, the thin film member 124 on the second portion 120 may further cover the edge 127 of the second portion 120, i.e., the side portion of the second portion 120 between the proximal disk face 126 and the distal disk face 128. Further, in other embodiments, the thin film member 124 on the second portion 120 may also cover the distal disk surface 128 of the second portion 120, i.e., the thin film member 124 covers the proximal disk surface 126, the rim 127, and the distal disk surface 128 of the second portion 120. On the basis, the above-mentioned various specific structures of the proximal end constraining member 112 disposed on the first portion 110 and the various specific ways of receiving and fixing the proximal ends of the plurality of braided wires 111 and the constraining region 118 of the thin film member 117 in embodiment 6 are also applicable to the proximal end constraining member 122 on the second portion 120, and are not repeated herein.
Example 8
The same parts of the occluding device of embodiment 8 as those of embodiment 6 are not described again, but the proximal end restriction member 112 described in embodiment 6 can be disposed at the distal end of the first portion 110 as the distal end restriction member 113, and the structures, the matching manner with the thin film member 117, the fixing manner in the restriction member, and other features of the two members are the same or similar.
Specifically, the membrane 117 of the first portion 110 covers at least a portion of the outer surface of the distal disc face 115 of the first portion 110, and the constricted region 118 of the membrane 117 is at least partially secured within the distal constriction 113 of the first portion 110. In other embodiments, the film 117 on the first portion 110 may further cover the edge 116 of the first portion 110. Further, the thin film member 117 on the first portion 110 may also cover the proximal disc surface 114 of the first portion 110, i.e., the thin film member 117 covers the distal disc surface 115, the rim 116 and the proximal disc surface 114 of the first portion 110.
As shown in fig. 18, the distal end retracting element 113 of the first portion 110 includes an inner sleeve 2121, an intermediate sleeve 2122 and an outer sleeve 2123, which are hollow and are sequentially sleeved from inside to outside. The proximal end of the outer sleeve 2123 and the proximal end of the intermediate sleeve 2122 enclose an outer proximal entrance 221 of the distal obturator 113, the proximal end of the intermediate sleeve 2122 and the proximal end of the inner sleeve 2121 enclose an inner proximal entrance 222 of the distal obturator 113, the distal end of the outer sleeve 2123 and the distal end of the intermediate sleeve 2122 enclose an outer distal entrance 223 of the distal obturator 113, and the distal end of the intermediate sleeve 2122 and the distal end of the inner sleeve 2121 enclose an inner distal entrance 224 of the distal obturator 113. The distal ends of the plurality of braided filaments 111 of the first portion 110 are received or secured within the distal end restriction 113 after passing through one of the outer proximal access 221, the inner proximal access 222, and the outer distal access 223 of the distal end restriction 113.
In some of these embodiments, when the distal ends of the plurality of braided filaments 111 of the first portion 110 are received and secured through the outer proximal access 221 of the distal end binding 113, the binding region 118 of the membrane 117 is at least partially received or secured between two adjacent cannulae via the outer distal access 223 or the inner distal access 224 of the distal binding 113. When the distal ends of the plurality of braided wires 111 of the first portion 110 are received and secured by the inner proximal portal 222 of the distal binding 113, the binding region 118 of the membrane 117 is at least partially received or secured between two adjacent cannulae via any one of the outer proximal portal 221, the outer distal portal 223, and the inner distal portal 224 of the distal binding 113. When the distal ends of the plurality of braided filaments 111 of the first portion 110 are received and secured by the outer distal entrance 223 of the distal crimp 113, the crimped region 118 of the membrane element 117 is at least partially received or secured between the inner sleeve 2121 and the intermediate sleeve 2122 via the inner distal entrance 224 of the distal crimp 113.
Example 9
The same parts of the occluding device of embodiment 9 as those of embodiment 8 will not be described again, and the difference between the two parts is mainly that the distal end restriction member 113 of the first part 110 described in embodiment 8 can be used as the distal end restriction member 123 of the second part 120.
Specifically, the film member 124 of the second portion 120 covers at least a portion of the outer surface of the distal disc face 128 of the second portion 120, and the constricted region 125 of the film member 124 is at least partially secured within the distal constriction 123 of the second portion 120. In other embodiments, the thin film member 124 on the second portion 120 may further cover the edge 127 of the second portion 120, i.e., the side portion of the second portion 120 between the proximal disk face 126 and the distal disk face 128. Further, in other embodiments, the thin film member 124 on the second portion 120 may also cover the proximal disc surface 126 of the second portion 120, i.e., the thin film member 124 covers the distal disc surface 128, the rim 127 and the proximal disc surface 126 of the second portion 120. On the basis, the above-mentioned various specific structures of the distal end restriction member 113 disposed on the first portion 110 and the various specific ways of receiving and fixing the distal ends of the plurality of braided wires 111 and the restriction region 118 of the thin film member 117 in embodiment 8 are also applicable to the distal end restriction member 123 on the second portion 120, and are not repeated herein.
It should be noted that, in other embodiments, the technical features related to the extension piece 119 disposed on the edge 116 of the first portion 110 or the edge 127 of the second portion 120 described in embodiment 5 are also applicable to embodiments 6 to 9, and are not described herein again.
Example 10
The occluding device 300 of example 10, as shown in figure 19, comprises a first portion 310 and a second portion 320 connected to the first portion 310. The first portion 310 includes a plurality of braided wires 111 and a relatively proximally located constriction (i.e., proximal constriction 112), the proximal ends of the plurality of braided wires 111 being received and secured within the proximal constriction 112 such that the proximal ends of the plurality of braided wires 111 are secured to the proximal constriction 112. The first portion 310 may further include a relatively distally located binding member (i.e., distal binding member 113), and the distal ends of the plurality of braided wires 111 are received and secured within the distal binding member 113 such that the distal ends of the plurality of braided wires 111 are secured to the distal binding member 113.
The plurality of braided filaments 111 of the first portion 310 may be braided to form a mesh tube shape and assume a disc or column shape after heat setting. The first portion 310 includes a proximal disc surface 114 and a distal disc surface 115 in the expanded state. The proximal disc surface 114 of the first portion 310 is cooperatively formed by at least a portion of the plurality of braided wires 111 of the first portion 310 that are relatively proximally located. The distal disc surface 115 of the first portion 310 is cooperatively formed by at least a portion of the plurality of braided wires 111 of the first portion 310 that are relatively distal. The portion of the first portion 310 where the proximal disk face 114 and the distal disk face 115 join forms the edge 116 of the first portion 310.
The proximal end constriction member 112 of the first portion 310 may be a hollow sleeve, may also be a double sleeve composed of the inner sleeve 1121 and the outer sleeve 1122 as described in any of the above embodiments, or may also be a three-layer sleeve composed of the inner sleeve 2121, the middle sleeve 2122 and the outer sleeve 2123, and the structure and the manner of constricting the braided wire 111 are the same or similar in technical features, and thus are not described again. The configuration of the distal constriction 113 of the first portion 310 is not limited and may be any of the hollow cannula, double cannula, triple cannula described above.
In this embodiment, the distal end constriction 113 of the first portion 310 is directly connected to the proximal end of the second portion 320 without a connection between the first portion 310 and the second portion 320; the second portion 320 includes a plurality of support rods 321, and the proximal ends of the support rods 321 are fixed to the distal end constriction 113 of the first portion 310; the support rod 321 is provided with an anchoring spike 322 for enhancing anchoring stability of the second portion 320 after penetrating into the body tissue. In other embodiments, the distal end constriction 113 of the first portion 310 may be disposed within the proximal end constriction of the second portion 320 and fixedly attached, thereby connecting the first portion 310 and the second portion 320. The specific structure of the second portion 320 is not limited, and in other embodiments, the second portion 120 described in embodiment 1 may be used.
The constricted region 318 of the first portion 310 refers to a portion near the central axis of the first portion 310 in the radial direction of the first portion 310, and the covered region may be a region in the range of 1/4 to 1/2 centered on the central axis of the first portion 310 and having a radius of the first portion 310. The constricted region 318 of the first portion 310 includes a gathered portion formed by converging a portion of the plurality of braided filaments 111. In one implementation of the present embodiment, the gathering portion includes a first gathering portion 311 and a second gathering portion 312, and a portion of the outer surface of the gathering portion constitutes a portion of the proximal disc surface 114. The first gathered portion 311 and the second gathered portion 312 are close to each other when no external force acts on the first portion 310, so that the proximal end constriction 112 of the first portion 310 is enclosed in the space enclosed by the first gathered portion 311 and the second gathered portion 312 in the first portion 310. Thereby avoiding the risk of thrombus formation at the proximal constriction 112 that is prone to occur when the proximal constriction 112 of the first portion 310 is closer to the proximal disc surface 114 than the proximal disc surface 114, i.e., the proximal constriction 112 protrudes proximally beyond the proximal disc surface 114.
In one embodiment, the occlusion device 300 is released by withdrawing the sheath proximally after the occlusion device 300 is connected to the distal end of the delivery cable, housed together in the sheath, and implanted into a cavity of an in vivo tissue such as the left atrial appendage to allow the occlusion device 300 to self-expand and deploy after the radial constraint imparted by the sheath is released. After release, the first portion 310, in one embodiment, has an edge portion of the distal disc surface 115 that abuts against tissue at the ostium of the left atrial appendage to occlude the ostium of the left atrial appendage. Referring to fig. 19 and 20A, after the sheath (not shown) is withdrawn, when the delivery cable 400 is not yet disconnected from the occlusion device 300, the distal end of the delivery cable 400 is still connected to the proximal constriction 112 of the first portion 310, which may be a threaded connection, without limitation. At this time, the first gathered portion 311 and the second gathered portion 312 are moved away from each other by an external force provided by the distal end portion of the conveying wire cable 400. Specifically, the portions of the first gathered portion 311 and the second gathered portion 312, which are opposed centering on the distal end portion of the delivery wire cable 400, abut on the distal end portion of the delivery wire cable 400, and their sectional views as viewed from the proximal end toward the distal end refer to fig. 20B.
Referring to fig. 21B, the cross-sectional view of the distal end of the delivery cable 400 as viewed from the proximal end to the distal end is shown in fig. 19 and 21A, after the distal end of the delivery cable 400 is disconnected from the proximal end constriction 112 of the first portion 310, and the first gathering portion 311 and the second gathering portion 312 are moved closer to each other due to the loss of the external force applied to the distal end portion of the delivery cable 400. The proximal disc surface 114 of the first and second bunched portions 311 and 312, which are close to each other, is approximately closed, so that the proximal bundling member 112 of the first portion 310 is enclosed in the space enclosed by the first and second bunched portions 311 and 312 in the first portion 310, specifically, enclosed between the proximal disc surface 114 and the distal disc surface 115 of the first portion 310. At this time, the proximal disc surface 114 is flat and closed, so after the occlusion device 300 is completely released, thrombus is not easily formed at the proximal disc surface 114 of the first portion 310 under the continuous flushing of blood flow, thereby improving the safety of the operation.
It should be noted that, referring to fig. 21B, a small gap (at the hole at the center of fig. 21B) may exist after the first gathering portion 311 and the second gathering portion 312 approach each other, and the maximum outer diameter of the gap is less than or equal to 5 mm, preferably less than or equal to 3 mm. In actual design, the size of the gap is generally smaller than the mesh size of the mesh of the braided mesh formed by the plurality of braided wires 111 or smaller than the inner diameter of the inner sleeve, so even if the gap still exists after the first gathered portion 311 and the second gathered portion 312 are close to each other, the formation of thrombus is not induced, and the proximal disc surface 114 formed by matching part of the outer surfaces of the first gathered portion 311 and the second gathered portion 312 can be regarded as still closed.
In another embodiment, if a gap still exists after the first gathering portion 311 and the second gathering portion 312 are close to each other, a closing member may be disposed at the gap so that the proximal disc surface 114 formed by the first gathering portion 311 and the second gathering portion 312 in cooperation is closed. The closing piece can be jelly such as an embolic agent and the like, and is characterized in that the shape is relatively stable after solidification and is not easy to permeate by liquid; the embolization agent may be injected into the space enclosed by the first and second bunches 311 and 312 after the delivery cable 400 is disconnected from the first portion 310, thereby filling the space and ensuring that the proximal disc surface 114 is closed. The closure member may also be a compressible and self-expandable cover attached to the first portion 310 so that the cover covers the gap after deployment, again ensuring that the proximal disc face 114 is closed. The closure member may be a component of other structures, which are not limited as long as the proximal disc surface 114 is closed, and are not listed here. In addition, blood flows enter the space enclosed by the gathering part through the gap and then are easy to be thrombosed, and formed thrombus is not easy to overflow from the gap and stably exists in the space, so that the space is filled up, and the disk surface is in a closed shape.
In other embodiments, the specific shape and number of the bunched portions and the specific location on the first portion 310 are not limited, as long as the bunched portions can surround the proximal bundling member 112 or the distal bundling member 113 inside the first portion 310 in a natural state or after the external force is removed, so as to avoid the risk that the proximal bundling member 112 or the distal bundling member 113 protrudes out of the first portion 310 and is liable to induce thrombus formation. In addition, since the gathered portions surrounding the proximal or distal binding member 112 or 113 are fitted to form a flat and closed disk surface, the risk of thrombus formation easily induced outside the first portion 310 can be completely avoided. It will be appreciated that the features associated with the bunched portion provided in first portion 310 may be substituted for those provided in second portion 320.
The occluding device 300 further includes one or more layers of the membrane 117 disposed on the first portion 310. As shown in FIG. 19, the film member 117 covers the proximal disc surface 114 and the rim 116 of the first portion 310, and thus the film member 117 also covers the outer surface of the first gathering portion 311 and the outer surface of the second gathering portion 312. The constricted region of the film member 117 is at least partially received or secured within the proximal constriction 112 of the first portion 310. It should be noted that, the technical features related to the thin film 117 in this embodiment are the same as or similar to the technical features related to the thin film 117 in embodiment 1, and are not described herein again. The film 117 provided on the first portion 310 can further improve the sealing performance and realize multi-layer sealing. In other embodiments, the membrane 117 may not be disposed on the first portion 310, as long as the first gathering portion 311 and the second gathering portion 312 cooperate to form a flat proximal disc surface 114, so as to avoid thrombus formation at the proximal disc surface 114. In other embodiments, the film 117 covers a portion of the outer surface of the first gathered portion 311, or covers a portion of the outer surface of the second gathered portion 312, or covers a portion of the outer surface of each of the first gathered portion 311 and the second gathered portion 312.
The specific shapes of the first gathering portion 311 and the second gathering portion 312 are not limited, and the two portions may be close to each other to form the closed proximal disc surface 114 with a flat surface. In other embodiments, as shown in fig. 22, the first gathering portion 311 includes a protrusion 313 and a recess 314, and the second gathering portion 312 includes a recess 315 and a protrusion 316; after the first gathering part 311 and the second gathering part 312 are close to each other, the convex part 313 of the first gathering part 311 abuts against the concave part 315 of the second gathering part 312, and the concave part 314 of the first gathering part 311 abuts against the convex part 316 of the second gathering part 312, so that the first gathering part 311 and the second gathering part 312 can be attached more sufficiently and more easily to form a relatively flat near-end disc surface 114, and thrombosis is prevented from being formed at the near-end disc surface 114. In another embodiment, the first gathering portion 311 includes a plurality of protrusions 313 and a plurality of recesses 314, the second gathering portion 312 includes a plurality of recesses 315 and a plurality of protrusions 316, after the first gathering portion 311 and the second gathering portion 312 are close to each other, the plurality of protrusions 313 of the first gathering portion 311 abut against one recess 315 of the second gathering portion 312 respectively, and the plurality of recesses 314 of the first gathering portion 311 abut against one protrusion 316 of the second gathering portion 312 respectively. Thus, when the first gathering portion 311 abuts the second gathering portion 312, the proximal disc surface 114 of the first portion 310 is closed, and the proximal end constriction 112 of the first portion 310 is closed inside the first portion 310 without contacting blood, thereby avoiding thrombus formation. In these embodiments, the first gathering portion 311 and the second gathering portion 312 partially overlap in the axial direction and also partially overlap in the radial direction. To ensure that the proximal disc surface 114 is formed to be closed, the first gathering portion 311 and the second gathering portion 312 abut each other at least in the radial direction after being brought close to each other. In other embodiments, a plurality of convex portions 313 of the first gathering portion 311 may abut against one of the concave portions 315 of the second gathering portion 312, and the first gathering portion 311 and the second gathering portion 312 may also abut against each other.
Further, in other embodiments, the first portion 310 is further provided with a reset piece, and after the first gathered portion 311 and the second gathered portion 312 release the external force, the reset piece gathers the first gathered portion 311 and the second gathered portion 312 together. In one embodiment, as shown in fig. 23, the restoring member 317 includes a magnet 3171 and a magnet 3172, which are opposite in magnetic property, the magnet 3171 is disposed on the first focusing portion 311, and the magnet 3172 is disposed on the second focusing portion 312. The number and specific arrangement positions of the magnets with the same magnetism are not limited, and for example, the magnets may be arranged on the proximal end constriction member 112 of the first portion 310 to attract the magnets arranged on the first gathering portion 311 and/or the second gathering portion 312. After the force applied to the first gathered portion 311 and the second gathered portion 312 by the conveying steel cable 400 is released, the first gathered portion 311 and the second gathered portion 312 are gathered together under the mutual attraction of the two magnets, so that the first gathered portion 311 and the second gathered portion 312 are promoted to approach each other and finally form a closed proximal disc surface 114.
In another embodiment, as shown in fig. 24, restoring member 318 includes a first restoring rod 3181 disposed adjacent to first gathering portion 311 and a second restoring rod 3182 disposed adjacent to second gathering portion 312, and first gathering portion 311 and second gathering portion 312 gather each other by first restoring rod 3181 and second restoring rod 3182. Specifically, one end of the first restoring rod 3181 is fixed to the distal end of the proximal constricting element 112 of the first portion 310, and the other end extends from the distal end of the proximal constricting element 112 toward the proximal disc surface 114 and radially outwardly at a position close to the proximal disc surface 114 for a distance without extending beyond the edge 116 of the first portion 310; second reset lever 3182 is disposed symmetrically about first reset lever 3181 about proximal constricting element 112. In another embodiment, the first and second restoring rods 3181 and 3182 are symmetrically disposed, and one end of the first restoring rod 3181 is fixed to the distal end of the proximal end constraining member 112, and the other end extends from the distal end of the proximal end constraining member 112 and then bends and extends toward the first converging portion 311; second restoring rod 3182 has one end fixed to the distal end of proximal end constraining member 112 and the other end extending from the distal end of proximal end constraining member 112 and curving toward second gathering portion 312. In these embodiments, when the first portion 310 is accommodated in the sheath, the first restoring rod 3181 and the second restoring rod 3182 both conform to the deformation of the first portion 310 to be approximately linear, and can restore the above shape after the first portion 310 is separated from the sheath, so as to facilitate the first gathering portion 311 and the second gathering portion 312 to approach each other and finally form the closed proximal disk surface 114.
In another embodiment, as shown in fig. 25, the restoring member 319 includes an elastic coil connecting the first gathering portion 311 and the second gathering portion 312. The elastic coil has good elasticity and can be radially outwardly expanded when the delivery cable 400 is connected with the proximal bunching member 112 so as not to obstruct the connection and prevent the separation of the first gathering portion 311 and the second gathering portion 312; it is also possible to cause the first gathered portion 311 and the second gathered portion 312 to gather together under the contraction action of the elastic coil after the delivery cable 400 is disconnected from the proximal end constriction 112. One or more elastic coils can be arranged according to requirements.
In some other embodiments, all the technical features described in any of the embodiments 1 to 9 may be correspondingly included, that is, the technical features described in embodiment 10 with respect to the first portion 310 may be regarded as a continuation of any of the embodiments 1 to 9, and the description of the same portions is omitted here.
The technical features of the embodiments described above may be arbitrarily combined, and for the sake of brevity, all possible combinations of the technical features in the embodiments described above are not described, but should be considered as being within the scope of the present specification as long as there is no contradiction between the combinations of the technical features.
The above-mentioned embodiments only express several embodiments of the present invention, and the description thereof is more specific and detailed, but not construed as limiting the scope of the invention. It should be noted that, for a person skilled in the art, several variations and modifications can be made without departing from the inventive concept, which falls within the scope of the present invention. Therefore, the protection scope of the present patent shall be subject to the appended claims.

Claims (10)

1. The utility model provides a plugging device, includes the first part, the first part includes many braids silk and bunches, the one end of many braids silk is fixed in the piece of bunching, the first part has at least one quotation, its characterized in that, some formation of many braids silk gathers together the portion through shape convergence, the piece of bunching is located gather together the portion and enclose the space of closing in, and by gather together at least one that the portion cooperation formed the quotation is flat and confined.
2. The occlusion device of claim 1, wherein the bunched portion comprises a first bunched portion and a second bunched portion, the first bunched portion and the second bunched portion being adjacent to each other when no external force is applied, so as to enclose the constriction in a space enclosed by the first bunched portion and the second bunched portion; the first gathering part and the second gathering part can be far away from each other under the action of external force.
3. The occlusion device of claim 2, wherein a maximum outer diameter of a gap formed by the first and second bunched portions approaching each other is less than or equal to 5 mm; or the first gathering part and the second gathering part are close to each other and are attached to each other at least in the radial direction.
4. The occlusion device of claim 3, wherein a closure member is provided at a gap formed by the first and second bunched portions, such that at least one of the disc surfaces formed by the bunched portions in cooperation is closed.
5. The occlusion device of claim 2, wherein the first gathered portion comprises at least one raised portion and the second gathered portion comprises at least one recessed portion, and wherein after the first gathered portion and the second gathered portion approach each other, at least one raised portion abuts one recessed portion.
6. The occlusion device of claim 2, wherein the first portion further comprises a restoring member, and the restoring member causes the first gathered portion and the second gathered portion to gather together after the first gathered portion and the second gathered portion are released from the external force.
7. The occlusion device of claim 6, wherein the restoring member comprises at least two magnets of opposite magnetic properties, and the first gathering portion and the second gathering portion gather together under the action of the at least two magnets.
8. The occlusion device of claim 6, wherein the restoring member comprises a first restoring rod disposed adjacent to the first gathering portion and a second restoring rod disposed adjacent to the second gathering portion, and the first gathering portion and the second gathering portion gather together under the action of the first restoring rod and the second restoring rod.
9. The occlusion device of claim 6, wherein the restoring member includes at least one elastic loop connecting the first gathered portion and the second gathered portion, the first gathered portion and the second gathered portion being gathered together under the action of the elastic loop.
10. The occlusion device of claim 1, further comprising a membrane member covering at least a portion of an outer surface of the bunched portion.
CN202010808213.2A 2020-08-12 2020-08-12 Plugging device Active CN114073560B (en)

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CN202211326549.0A CN115708702A (en) 2020-08-12 2020-08-12 Plugging device
CN202211310370.6A CN115670565A (en) 2020-08-12 2020-08-12 Plugging device
CN202010808213.2A CN114073560B (en) 2020-08-12 2020-08-12 Plugging device
CA3186828A CA3186828A1 (en) 2020-08-12 2021-08-11 Plugging device
EP21855581.1A EP4197455A4 (en) 2020-08-12 2021-08-11 Plugging device
PCT/CN2021/112111 WO2022033530A1 (en) 2020-08-12 2021-08-11 Plugging device
US18/040,180 US20230320713A1 (en) 2020-08-12 2021-08-11 Plugging device

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